Implementation of a triadic network case management intervention for younger Black sexual minority men

对年轻黑人性少数男性实施三元网络案例管理干预

基本信息

批准号：
10548326
负责人：
Alida M Bouris
金额：
$ 73.8万
依托单位：
UNIVERSITY OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-09 至 2027-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10548326
关键词：
Accountability Address Adoption Attention Black race COVID-19 Caring Case Management Case Manager Client Climate Communities Computerized Medical Record Consolidated Framework for Implementation Research Consultations Consumption Contact Tracing Continuity of Patient Care Counseling Data Data Collection Development Documentation Economics Effectiveness Employment Epidemic Evaluation Event Food Foundations HIV Health Insurance Healthcare Housing Human Hybrids Individual Infrastructure Intervention Intuition Job Satisfaction Maintenance Mediating Mental Health Methods Modeling Morale Outcome Participant Personal Satisfaction Plant Roots Prevention Reach Effectiveness Adoption Implementation and Maintenance Reporting Resources Services Shelter facility Social Work Structure Supervision Support System Supported Employment Surveys System Testing Time Trainers Training Training Triad Acrylic Resin Violence Viral Load result Vulnerable Populations Work aged base burnout cost design effectiveness evaluation effectiveness testing effectiveness-implementation RCT evidence base experience food security hybrid type 2 trial implementation evaluation implementation framework implementation outcomes implementation strategy improved innovation member pre-exposure prophylaxis prevent sexual minority men skills substance use transmission process

项目摘要

We will conduct a Hybrid Type II effectiveness-implementation randomized controlled trial of a Case Management Dyad (CM2) intervention, an evidence-based triadic social work intervention that uses a case manager dyad to engage younger Black sexual minority men (YBSMM) aged 18-35 in economic stability services. CM2 innovates on existing care continuum engagement models by (1) prioritizing resource counseling to improve HIV care and prevention continuum outcomes, and (2) utilizing a triadic network approach where a client meets with a dyadic case management team in tandem–forming a triad with the client–which provides additional supports for the client and the case managers. CM2 is timely given that intensive interventions are critical for engaging community members who have not benefited from existing Getting to Zero efforts. CM2 will also test robust implementation strategies to support CM2 implementation and to enhance the professional development and prevent burnout in the HIV front-line workforce, some of whom are directly impacted by HIV. The CM2 intervention and associated implementation strategies emerge from prior work conducted by the Investigative Team. We will build upon these experiences, infrastructures, and relationships to evaluate the effectiveness and implementation of CM2 among N=180 YBSMM. Data collection, at baseline, and every 6 months over 18 months, will include surveys and electronic medical record data. To study implementation, we will use the Consolidated Framework for Implementation Research as the determinant framework and RE-AIM as the evaluation framework. The specific aims are to: (Aim 1a) Evaluate the primary (financial well-being, food security) and secondary (integrated PrEP persistence/viral load suppression) effectiveness of CM2 vs routine Ryan White Non-Medical Case Management and PrEP Resource Counseling among YBSMM; (Aim 1b). Evaluate the effectiveness (time to successful resource referral completion, CM job satisfaction, CM burnout and CM-client relationship) of the CM2 intervention vs. routine Ryan White Case Management and/or PrEP Resource Counseling among case manager study participants; (Aim 2a) Determine the extent to which financial well-being and food security mediate the relationship between CM2 and downstream 18-month integrated care continuum outcomes; (Aim 2b) Explore potential differential effects of CM2 on primary (resource) and secondary (care continuum) outcomes, based on mental health, substance use, housing, employment and HIV serostatus; and (Aim 3) Evaluate implementation strategies and outcomes at both YBSMM and case manager levels using RE- AIM to study reach, adoption, implementation, and maintenance. Implementation strategies include individual and dyadic supervision, team consultation, and a train-the-trainer model, and implementation outcomes are acceptability, feasibility, appropriateness, feasibility, fidelity and cost. If successful, CM2 will intensify existing case management resource support systems, which will not only impact the lives and care continua of YBSMM, but also fulfill an ending the epidemic priority of revitalizing and sustaining the HIV frontline workforce.

我们将进行案例的II型混合有效性随机对照试验管理Dyad（CM2）干预，一种基于证据的三元社会工作干预措施，使用案例经理Dyad与18-35岁的经济稳定年轻的年轻黑人性少数民族（YBSMM）参与服务。 CM2关于现有护理持续参与模型的创新（1）优先考虑资源咨询为了改善艾滋病毒的护理和预防持续的结果，（2）使用三合会网络方法客户与二元组案件管理团队会面，并与客户形成三合会 - 提供为客户和案件经理提供其他支持。鉴于强化干预措施是及时的对于没有从现有的零努力中受益的社区成员而言，至关重要。 CM2会还可以测试支持CM2实施并增强专业人员的强大实施策略发展并防止艾滋病毒前线劳动力中的倦怠，其中一些人直接受到艾滋病毒的影响。 CM2干预和相关的实施策略来自于先前的工作调查团队。我们将基于这些经验，基础设施和关系来评估 n = 180 ybsmm中CM2的有效性和实施。数据收集，基线和每6个在18个月的时间内，将包括调查和电子病历数据。为了研究实施，我们将使用合并的框架作为确定的框架并重新使用的框架作为评估框架。具体目的是：（目标1A）评估主要福祉（财务状况，食物）安全性）和次级（综合准备持续性/病毒载荷抑制）CM2与例程的有效性 Ryan White非医学案例管理和YBSMM中的准备资源咨询；（AIM 1B）。评估有效性（成功的资源转介完成，CM工作满意度，CM倦怠和 CM2干预与常规Ryan White Case Management和/或准备资源的CM-CLIENT关系）案例经理研究参与者之间的咨询；（AIM 2A）确定财务福祉的程度粮食安全调解了CM2和下游18个月综合护理连续体之间的关系结果；（AIM 2B）探索CM2对主要（资源）和次要的潜在差异影响（护理基于心理健康，药物使用，住房，就业和艾滋病毒血清的结果；和（AIM 3）使用重新评估YBSMM和案例经理级别的实施策略和结果旨在研究覆盖范围，采用，实施和维护。实施策略包括个人以及二元监督，团队咨询和火车训练模式以及实施成果是可接受性，可行性，适当性，可行性，忠诚度和成本。如果成功，CM2将加剧现有案例管理资源支持系统，这不仅会影响YBMM的生活和关怀，还会影响而且还履行了振兴和维持艾滋病毒前线劳动力的流行优先事项。